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Consumers believe that cigarettes with these and similar descriptors are more appealing, healthier and/or less harmful than cigarettes without these descriptors.211 Moreover, NAS advertising prominently features nature-related imagery, highlights the brands sustainable farming practices and exploits Native American symbolism, all of which may also misrepresent product risk.1215 This combination of brand characteristics has yielded a consumer base that, compared with those who smoke other brands, is more likely to misunderstand the relative harm of NAS compared with other cigarettes.16 There is no evidence that smoking NAS cigarettes reduces disease risk, and emission studies find substantial variability in exposure to harmful constituents in NAS cigarettes depending on the NAS variety tested, the studys methods and the compounds under investigation.1723 Federal regulators have recognised that NAS uses deceptive marketing tactics and have taken limited regulatory action against the brand, resulting in the addition of disclaimer statements on packs and advertisements about the relative harm of natural or organic commercial tobacco, and the removal of additive-free and some instances of natural from NAS labelling and marketing.24 The US Food and Drug Administrations (FDA) Center for Tobacco Products has not publicly initiated regulatory action against the use of organic, perhaps because the descriptors use Footnotes Twitter @dannygiovenco Contributors JP conceived the article and lead the writing team

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